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目的分析不同种类糖皮质激素诱导缓解治疗儿童原发性肾病综合征的效果和安全性。方法 95例确诊初治原发性肾病综合征患儿随机分为两组,实验组(48例)和对照组(47例),实验组给予甲基泼尼松龙诱导缓解治疗,对照组给予泼尼松诱导缓解治疗,观察尿蛋白转阴时间和不良反应情况。结果实验组尿蛋白转阴平均时间(5.4±0.6)d明显低于对照组(7.8±0.7)d,差异有统计学意义(P<0.01);实验组治疗后缓解率93.75%明显高于对照组78.72%,差异有统计学意义(P<0.05);实验组不良反应发生率16.67%明显低于对照组36.17%,差异有统计学意义(P<0.05)。结论甲基泼尼松龙诱导缓解治疗儿童原发性肾病综合征效果优于泼尼松,能够缩短诱导缓解时间,安全可靠,值得临床上对其作用机制和安全性继续探讨。
Objective To analyze the efficacy and safety of different kinds of glucocorticoid induced remission in treating children with primary nephrotic syndrome. Methods Ninety-five children with newly diagnosed primary nephrotic syndrome were randomly divided into two groups: experimental group (48 cases) and control group (47 cases). The experimental group was treated with methylprednisolone induction and the control group Prednisone-induced remission therapy, observed urine protein negative conversion time and adverse reactions. Results The urinary proteinuria in the experimental group (5.4 ± 0.6) d was significantly lower than that in the control group (7.8 ± 0.7) d, the difference was statistically significant (P <0.01). The remission rate of the experimental group was significantly higher than that of the control The difference was statistically significant (P <0.05). The incidence of adverse reactions in experimental group was significantly lower than that in control group (16.67% vs 36.17%, P <0.05). Conclusion Methylprednisolone is more effective than prednisone in inducing remission in children with primary nephrotic syndrome. It can shorten the time of induction remission and is safe and reliable. It is worth to continue to discuss its mechanism and safety in clinic.